Associations between Hemoglobin Concentrations and the Clinical Characteristics of Patients with Type 2 Diabetes

Chung, Jin Ook; Cho, Dong Hyeok; Chung, Dong Jin; Chung, Min Young

doi:10.3904/kjim.2012.27.3.285

Cited by 6 publications

(7 citation statements)

References 32 publications

(37 reference statements)

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“…Compared with patients with ≤ 10 years duration of DM, the odds ratio of developing anemia in individuals with ˃ 10 years was approximately three times. This finding is in agreement with the previous studies in Australia, 12 Korea, 76 India, 49,77 and Finote Selam. 32 The reason for this increased chance of anemia development with an increasing duration of DM may be due to the chronic effects of hyperglycemia.…”

Section: %supporting

confidence: 94%

<p>Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study</p>

Taderegew¹,

Gebremariam²,

Tareke³

et al. 2020

JBM

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Purpose: Anemia is one of the common complications of diabetes mellitus (DM), which has an adverse effect on the progression and development of other diabetes-related complications. In spite of this, relatively little information is available on the prevalence of anemia and associated factors among type 2 diabetes mellitus (T2DM) patients in Ethiopia, particularly in the study area. Thus, this study assessed the prevalence of anemia and associated factors among T2DM patients at Debre Berhan Referral Hospital (DBRH), NorthEast , Ethiopia. Patients and Methods: A hospital-based cross-sectional study was conducted from April 1 to May 30, 2019, among 249 T2DM patients with follow up at DBRH, selected using a systematic random sampling technique. Data were collected by face-to-face interviews, anthropometric measurements, and laboratory tests; such as hemoglobin measurements, red blood indices, and serum creatinine analysis. The data were coded and entered into Epi-data manager version 4.4.1.0, and analysis by using SPSS version 22 was carried out. To identify the determinant factors of anemia, bivariate and multivariate logistic regression analyses were performed. P-value <0.05 was considered as statistically significant. Results: The study showed 20.1% of the participants were anemic. Being age >60 years (AOR=3.06, 95% CI: 1.32-7.11), poor glycemic control (AOR=2.95, 95% CI: 1.22-7.15), eGFR 60-89.9 mL/min/1.73m 2 (AOR=2.91, 95% CI: 1.15-7.37), eGFR <60 mL/min/1.73m 2 (AOR=6.58, 95% CI: 2.42-17.93), DM duration >10 years (AOR= AOR=2.75, 95% CI: 1.17-6.48), and having diabetic complications (AOR=3.81, 95% CI: 1.65-8.81) were significantly associated with anemia. Conclusion: One out of five T2DM patients had anemia. Poor glycemic control, decreased eGFR, presence of DM complications, duration of DM >10 years, and age >60 years were significantly associated with the occurrence of anemia among T2DM. Regular screening for anemia in all T2DM patients may help in the early detection and management of anemia.

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Section: %supporting

confidence: 94%

<p>Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study</p>

Taderegew¹,

Gebremariam²,

Tareke³

et al. 2020

JBM

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“…In our previous study that was conducted in 337 male patients with type 2 DM, we found an independent association between Hb concentrations and ΔC-peptide concentrations, [ 35 ] implying that Hb might be related to C-peptide concentrations. In the present study, we observed that the presence of anemia was inversely associated with the fasting C-peptide, postprandial C-peptide, and ΔC-peptide concentrations in the multivariable analysis, and these relations were independent of gender.…”

Section: Discussionmentioning

confidence: 82%

Anemia is inversely associated with serum C-peptide concentrations in individuals with type 2 diabetes

Chung¹,

Park

Cho³

et al. 2018

Medicine

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The purpose of the study was to test the hypothesis that anemia is related with serum C-peptide concentrations in individuals with type 2 diabetes mellitus (DM).This cross-sectional study was carried out in 1300 individuals with type 2 DM. We measured fasting C-peptide, 2-hour postprandial C-peptide, and postprandial C-peptide minus fasting C-peptide (ΔC-peptide) concentrations. Anemia was defined as hemoglobin (Hb) concentrations <130 g/L in men and <120 g/L in women. Anemia was graded into 2 groups: grade I anemia of Hb concentrations ≥110 g/L and grade II anemia of Hb concentrations <110 g/L.Fasting C-peptide, postprandial C-peptide, and ΔC-peptide concentrations were lower in individuals with anemia. According to the grade of anemia, the average C-peptide concentrations differed significantly after adjusting for other covariates. In the multivariable model, the statistically significant relation between anemia and serum C-peptide concentrations remained after adjusting for confounders, including age, gender, family history of diabetes, body mass index, duration of diabetes, glycated Hb, free fatty acids, hypertension, and hyperlipidemia (fasting C-peptide concentration: β = –0.057, P = .032; postprandial C-peptide concentration: β = –0.098, P < .001; ΔC-peptide concentration: β = –0.095, P < .001).Anemia was inversely associated with serum C-peptide concentrations in individuals with type 2 DM.

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“…Low hemoglobin concentrations are more common in diabetic patients than nondiabetics and hyperglycemia has been shown to decrease red cell survival by 13%. 56 There may be an increased risk of severe diabetic retinopathy in individuals with hemoglobin levels below 12 g/dL, 57 , 58 although this association diminished after adjusting for diabetes duration in another study. 56 Lastly, a cross-sectional study of over 3000 patients found elevated serum calcium to be a risk factor for vision-threatening diabetic retinopathy, 59 and in vivo histology of the retina revealed elevated serum calcium was associated with retinal photoreceptor apoptosis in diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 91%

Bias or biology? Importance of model interpretation in machine learning studies from electronic health records

2022

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Objective The rate of diabetic complication progression varies across individuals and understanding factors that alter the rate of complication progression may uncover new clinical interventions for personalized diabetes management. Materials and Methods We explore how various machine learning (ML) models and types of electronic health records (EHRs) can predict fast versus slow onset of neuropathy, nephropathy, ocular disease, or cardiovascular disease using only patient data collected prior to diabetes diagnosis. Results We find that optimized random forest models performed best to accurately predict the diagnosis of a diabetic complication, with the most effective model distinguishing between fast versus slow nephropathy (AUROC = 0.75). Using all data sets combined allowed for the highest model predictive performance, and social history or laboratory alone were most predictive. SHapley Additive exPlanations (SHAP) model interpretation allowed for exploration of predictors of fast and slow complication diagnosis, including underlying biases present in the EHR. Patients in the fast group had more medical visits, incurring a potential informed decision bias. Discussion Our study is unique in the realm of ML studies as it leverages SHAP as a starting point to explore patient markers not routinely used in diabetes monitoring. A mix of both bias and biological processes is likely present in influencing a model’s ability to distinguish between groups. Conclusion Overall, model interpretation is a critical step in evaluating validity of a user-intended endpoint for a model when using EHR data, and predictors affected by bias and those driven by biologic processes should be equally recognized.

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Associations between Hemoglobin Concentrations and the Clinical Characteristics of Patients with Type 2 Diabetes

Cited by 6 publications

References 32 publications

<p>Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study</p>

<p>Anemia and Its Associated Factors Among Type 2 Diabetes Mellitus Patients Attending Debre Berhan Referral Hospital, North-East Ethiopia: A Cross-Sectional Study</p>

Anemia is inversely associated with serum C-peptide concentrations in individuals with type 2 diabetes

Bias or biology? Importance of model interpretation in machine learning studies from electronic health records

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